Thank you for using the Culture Pass.

The Culture Pass program is a joint project of Act One, the partner libraries and and the participating arts organizations. We appreciate your participation in our survey and value your input. Your personal data will not be shared or individually compiled.

* 1. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

* 2. What is your email address?  *Will only be used for Culture Pass/Act One information. Will not be shared.

* 3. How many adults (18+) live in your household?

* 4. How many children, by age, currently live in your household? Leave blank if no children live in your household.

* 5. What was your household income in 2016?

* 6. What is your ethnicity? (Please select all that apply.)

* 7. What is the highest level of education you have completed?

* 8. Are you, or is someone in your household, a veteran or currently serving in the military?

* 9. How did you learn about the Culture Pass?

* 10. In what county did you check out your Culture Pass?

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